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Introduction Sexually transmitted infections (STIs) are common in our environment, and trends have been increasing in the last few years. Different methods for STIs diagnosis have been applied by microbiology laboratories over years, but real-time PCR has improved this process. Our objective was to evaluate VIASURE Sexually Transmitted Diseases Real-Time PCR Detection kit (CerTestBiotec, S.L.) comparing with the real-time PCR technique used in our laboratory (Allplex™ STI7 Essential Assay, Seegene) which was considered as reference assay. Methods A total of 948 samples from different sites (vaginal, endocervical, urethral, rectal, pharyngeal swabs and urine samples) were analyzed from July to September 2018. Results A discordant result was obtained in 4.5% (43 samples). These discrepancies were mainly observed in threshold cycle (Ct) value next to the limit of detection. The k coefficient obtained shows a very high agreement between both methods with k values from 0.92 to 0.99. Conclusions VIASURE Sexually Transmitted Diseases Real-Time PCR Detection kit provides a very good correlation with Allplex STI7 and therefore, it's a good tool for the diagnostic of STIs. Positive results with Ct value obtained from 35 and low amplification signal should be applied with caution and should be interpreted based on the patient's clinical data.

Resumen Fundamento y objetivo El objetivo del estudio fue analizar las muertes por enfermedades no asociadas directamente con el sida en una cohorte de pacientes con VIH atendidos entre 1998 y 2011. Pacientes y metodo La informacion sobre las causas de la muerte se recogio retrospectivamente y se clasificaron siguiendo el algoritmo CoDe. Se compararon las caracteristicas de los pacientes en 2 periodos: 1998-2004 y 2005-2011. Resultados Fallecieron 159 de los 1.070 pacientes atendidos en ese espacio de tiempo, 56 (35%) por eventos sida y 86 (54%) por eventos no sida (ENOS); en 17 (11%) no pudo determinarse la causa. Globalmente, las principales causas de muerte fueron infecciones (32%), neoplasias (17%) y muertes no naturales (17%). Durante el segundo periodo hubo menor mortalidad por sida (18,5 vs 47%; p Conclusiones Las neoplasias no asociadas a sida, las muertes no naturales y los eventos cardiovasculares constituyen ahora causas importantes de muerte en los pacientes con VIH. En los ultimos anos la mayoria de los pacientes fallecidos estan en TAR y suprimidos virologicamente.

INTRODUCTION The GESIDA and National AIDS Plan panel of experts propose «preferred regimens» of antiretroviral treatment (ART) as initial therapy in HIV infected patients for 2012. The objective of this study is to evaluate the costs and the efficiency of initiating treatment with these «preferred regimens». METHODS Economic assessment of costs and efficiency (cost/efficacy) using decision tree analysis model. Efficacy was defined as the probability of having a viral load

In this update, antiretroviral therapy (ART) is recommended for all patients infected by type 1 human immunodeficiency virus (HIV-1). The strength and grade of the recommendation varies with clinical circumstances, number of CD4 cells, comorbid conditions and prevention of transmission of HIV. The objective of ART is to achieve an undetectable plasma viral load. Initial ART should always comprise a combination of 3 drugs, including 2 nucleoside reverse transcriptase inhibitors and a third drug from a different family (non-nucleoside reverse transcriptase inhibitor, protease inhibitor, or integrase inhibitor). This update presents the causes and criteria for switching ART in patients with undetectable plasma viral load and in cases of virological failure. An update is also provided for the specific criteria for ART in special situations (acute infection, HIV-2 infection, and pregnancy) and with comorbid conditions (tuberculosis or other opportunistic infections, kidney disease, liver disease, and cancer). (C) 2014 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.

To provide an update of guidelines from the Spanish AIDS Study Group (GESIDA) and the National AIDS Plan (PNS) committee on the prevention of opportunistic infections in adult and adolescent HIV-infected patients.These consensus recommendations have been produced by a group of experts from GESIDA and/or the PNS after reviewing the earlier document and the scientific advances in this field in the last years. The system used by the Infectious Diseases Society of America and the United States Public Health Service has been used to classify the strength and quality of the data.This document provides a detailed review of the measures for the prevention of infections caused by viruses, bacteria, fungi and parasites in the context of HIV infection. Recommendations are given for preventing exposure and for primary and secondary prophylaxis for each group of pathogens. In addition, criteria are established for the withdrawal of prophylaxis in patients who respond well to highly active antiretroviral therapy (HAART).HAART is the best strategy for the prevention of opportunistic infections in HIV-positive patients. Nevertheless, prophylaxis is still necessary in countries with limited economic resources, in highly immunodepressed patients until HAART achieves beneficial effects, in patients who refuse to take or who cannot take HAART, in those in whom HAART is not effective, and in the small group of infected patients with inadequate recovery of CD4+ T lymphocyte counts despite good inhibition of HIV replication.

To validate the Spanish version of the MOS-HIV questionnaire for measuring quality of life in HIV-infected patients.275 HIV-infected patients distributed in three diagnostic categories (asymptomatic, symptomatic and AIDS) and 40 blood donors as healthy controls were recruited from 23 Spanish hospitals and answered the MOS-HIV. Feasibility was assessed by analysing the mean time of administration and the percentage of patients with missing response. Internal consistency was assessed using Cronbach's alpha. A subsample of 48 stable patients completed the questionnaire on two occasions to assess test-retest reliability using the Intraclass Correlation Coefficient. Validity was assessed by calculating the area under the Receiver's Operating Characteristics (ROC) curve between patients and controls, and by correlating MOS-HIV scores with the VAS of Euroqol, the number of symptoms, the CD4+ count and viral load.The mean time of administration was 16 minutes and 18.9% of patients did answer the MOS-HIV with some missing response. All the scales showed high internal consistency (Cronbach's alpha = 0.78-0.89). Test-retest reliability of Physical Health (PHS) and Mental Health (MHS) Summary Scores was 0.58 y 0.85, respectively. The MOS-HIV discriminated between patients and controls (ROC = 0.77, CI = 0.69-0.85 and ROC = 0.80, CI = 0.72-0.88, for the PHS and MHS, respectively). The correlation of the scales of the MOS-HIV with the CD4+ count and viral load was low (r = -0.26 to 0.3), and with the number of symptoms and the VAS of Euroqol were moderate (r = -0.28 to -0.49 and r = 0.4 to 0.66, respectively).Considering evidence-based medicine principles, the Spanish version of the MOS-HIV has shown adequate feasibility, reliability and validity for its use in clinical research, but their use in clinical practice is limited because of their time of administration, the low reproducibility of some scales and the features of their scoring system.

We have reviewed 29 episodes of pneumococcal meningitis seen in a 6-year period (1983-1988) in 11 pediatric patients and 16 adults. An underlying disease or condition was present in 81.5% of cases, in 55.5% there was an anatomical defect, either congenital, acquired or traumatic in origin. Gram stain of CSF was positive in 86% of cases, and latex test was positive in the 22 CSF samples analyzed with this technique. MIC for penicillin ranges from 1 to 2 mcg/ml in 51.7% of cases. These isolates were also resistant to tetracycline (100%), trimethoprim-sulfamethoxazole (100%) and chloramphenicol (87%). All strains isolated were sensitive to vancomycin, rifampin and cefotaxime. Of all 14 episodes due to penicillin-sensitive strains, 10 cases were treated with this drug and in 4 cases, third generation cephalosporins were prescribed. All cases showed good clinical response. Of all 15 episodes due to penicillin-resistant strains, vancomycin was used first in 10 cases, cefotaxime in three, moxalactam in one and ampicillin plus chloramphenicol in another. Treatment failures (one in cefotaxime and one in moxalactam group) were solved with vancomycin. Of all 12 patients treated with vancomycin, clinical and microbiological cure was achieved in 10 cases. Two additional patients died, one with sterile CSF after 45 days of admission and one few hours after admission. Our data give support to vancomycin as a useful therapeutic option in the treatment of pneumococcal meningitis due to penicillin-resistant strains.